CMS Price Transparency Data

Orthotic fitting and training

Facility: Norton-King's Daughters' Health

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $159
Cash Discount Price: $41
vs. Medicare Baseline: 3.45x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Norton-King's Daughters' Health is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 3.45x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$159

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)

Cash / Self-Pay: $41 (89%)

Insurance Median: $159 (345%)

Cash: $41 (89% of Medicare)

Ins. Median: $159 (345% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $46.09 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 345% of the Medicare baseline (a markup of 245%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$29 - $165	63%
Blue Cross Blue Shield	$29 - $68	63%
Humana	$29 - $43	63%
Managed Health Services Of Kentucky	$29	63%
Passport By Molina	$29	63%
UnitedHealthcare	$43 - $148	93%
Managed Health Services	$45 - $67	98%
Caresource Of Kentucky	$61	132%
Caresource Of Indiana	$65	141%
Custom Design Benefits	$87 - $94	189%
Cigna	$150 - $160	325%
Encore	$150 - $160	325%
Quality Care Partners	$157 - $167	341%
Bluegrass	$158 - $169	343%
First Health	$158 - $169	343%
Healthlink	$158 - $169	343%
Vha/Tristate	$158 - $169	343%
Multiplan/Phcs	$162 - $173	351%
Indiana Health Network	$167 - $179	362%
Siho	$167 - $179	362%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $41.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Norton-King's Daughters' Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.